The treatment of alcohol dependence is of considerable importance to those afflicted with the problem, to the medical profession and to society in general, but safe and effective treatments for the condition are still needed and sought after. When an alcohol-dependent person stops ingesting alcohol or alcoholic beverages, complete detoxification is probably not achieved in a few days of "sobering up". It is thought that several months of abstinence from alcohol are required before vital organ systems are restored to normal. During this postwithdrawal phase, drug therapy is often considered beneficial in discouraging a patient from resuming the use of alcohol but the drug therapy presently used to treat alcohol-dependent people is attended by numerous drawbacks.
The most common drug used in this postwithdrawal treatment is disulfiram. Disulfiram apparently acts as a chelating agent capable of chelating the zinc of alcohol dehydrogenase, the iron and molybdenum of aldehyde dehydrogenase and the copper of dopamine-beta-hydroxylase. Whatever the precise mechanism by which disulfiram operates, patients receiving the drug refrain from drinking alcoholic beverages to avoid unpleasant and possibly toxic or even fatal effects stemming from the interaction of disulfiram with ethanol. Within a few minutes after ingesting even minute quantities of alcohol in disulfiram-treated patients, a remarkable reaction often occurs. The patient first notes a feeling of warmth in the face. The skin, especially in the upper chest and face, becomes bright red and a pounding sensation occurs in the head and chest. In addition, respiratory difficulties, nausea, vomiting, sweating, weakness, dizziness, blurred vision, and confusion may also be part of the reaction. It is unclear exactly how long after a single dose of disulfiram a reaction will still occur, although 12 to 24 hours is a common estimate. With large doses of alcohol and disulfiram, the reaction can be extremely severe and life threatening. The reaction is usually proportional to the amount of alcohol ingested and the dose of disulfiram. Reactions may last a few minutes in mild cases to several hours in severe ones. Some patients taking disulfiram accidentally ingest ethanol or deliberately take it in an attempt to verify the efficacy of the drug or to kill themselves. Some patients with brief mild reactions never seek medical attention; some prolonged severe reactions require immediate medical attention.
In addition to these hazardous reactions, disulfiram's effectiveness is relatively short-lived. For instance, a single dose of disulfiram may only be effective for about 12 to 24 hours. This limits the drug's clinical usefulness because disulfiram-treated patients can easily discontinue use on their own, making it difficult to monitor and maintain adherence to prescribed disulfiram treatment. Applicant has overcome these drawbacks with the present invention which provides a method of treating alcohol dependence without the hazardous reactions that result from combining disulfiram with alcohol, particularly ethanol, and which is effective for a longer period of time.